Delirium Dementia Mild Neurocognitive Disorder Major Neurocognitive Disorder Alzheimer Disease Frontotemporal Lobar Degeneration Lewy Body Disease Vascul

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Sample questions from Delirium Dementia Mild Neurocognitive Disorder Major Neurocognitive Disorder Alzheimer Disease Frontotemporal Lobar Degeneration Lewy Body Disease Vascul

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During a home visit, a 79-year-old with Alzheimer disease is found newly inattentive and unable to follow familiar instructions. The client has a temperature of 38.2 C, HR 106/min, RR 22/min, BP 108/64 mm Hg, and SpO2 95% on room air. Which action should the nurse take first?

   • A.Teach the family to use a memory notebook
   • B.Reassure the family that this is expected disease progression
   • C.Recommend increasing the client's usual exercise
   • D.Arrange prompt medical evaluation for an acute cause of the change

   Rationale: A sudden change in attention and function with fever and tachycardia suggests delirium from an acute illness and requires prompt assessment. Reassurance, memory aids, and exercise do not address a potentially urgent cause. A sudden change from baseline should not be attributed to dementia without evaluation.

2. 2.At change of shift in a medical unit, an 82-year-old with dementia has new agitation, poor attention, and a temperature of 38.1 C. The client has a urinary catheter and cannot describe symptoms reliably. Which actions should the nurse take to assess for reversible causes? Select all that apply.

   • A.Request evaluation for infection and other acute illness
   • B.Obtain a focused history from a person familiar with the client's baseline
   • C.Review recent medication additions and dose changes
   • D.Use a sedative before completing an assessment
   • E.Assume the change is permanent because dementia is documented
   • F.Assess hydration, pain, oxygenation, and bowel and bladder status

   Rationale: Medication effects, dehydration, pain, hypoxia, retention, constipation, infection, and other acute illnesses can precipitate delirium. A reliable informant helps distinguish an acute change from baseline dementia. The change should not be presumed permanent, and sedation before assessment may obscure findings and increase harm.

3. 3.In an outpatient neurology clinic, a 67-year-old reports gradually worsening word-finding and planning over 18 months but remains independent with finances, medications, and personal care. Which interpretation is most appropriate?

   • A.The symptoms establish delirium despite the gradual course
   • B.The pattern is consistent with mild neurocognitive disorder and warrants evaluation
   • C.The client meets criteria for major neurocognitive disorder because symptoms are progressive
   • D.The client has normal cognition because independent activities are preserved

   Rationale: Mild neurocognitive disorder involves cognitive decline while independence in everyday activities is largely preserved. Major neurocognitive disorder interferes with independence, and delirium typically has an acute or fluctuating course with impaired attention. Preserved independence does not mean the reported decline should be dismissed as normal aging.

4. 4.At change of shift, a charge nurse receives report on four clients. Which client should the nurse assess first?

   • A.A 69-year-old with dementia who is newly difficult to arouse after a fall
   • B.An 81-year-old with chronic insomnia who requests a warm drink
   • C.A 76-year-old with stable Alzheimer disease who asks the same question repeatedly
   • D.A 72-year-old with mild cognitive impairment awaiting discharge teaching

   Answer and rationale are in the full material.

5. 5.In a long-term care facility, an 84-year-old with moderate Alzheimer disease has difficulty choosing clothing but can dress after clothes are laid out. Which care plan best supports function?

   • A.Provide several outfit choices and ask the client to select one
   • B.Dress the client completely to prevent frustration
   • C.Lay out two appropriate clothing choices and allow time for the client to dress
   • D.Tell the client to hurry so the routine stays on schedule

   Answer and rationale are in the full material.